Ronei Rodolfo Iacobelli, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12807 Issued in MI

Practice address

5647 Sashabaw Rd
Clarkston, MI 48346

Phone

(248) 625-2515

Fax

(248) 625-2297

NPI assigned

Jan 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthodontic Specialists LTD PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Clarkston, MI
  • NPI 1306994777
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487702858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5647 SASHABAW RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-625-2515",
            "fax_number": "248-625-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5647 SASHABAW RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-625-2515",
            "fax_number": "248-625-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACOBELLI",
        "first_name": "RONEI",
        "middle_name": "RODOLFO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "12807",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "53533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Hu, PHARMD
• Kalei Hubert-McLennan
• Jessica Humiston, LPC
• Nonnie L. Humphreys, LMSW
• Sam Henry Hunt
• Amy Iannarone, PHARM D
• Ideal Home Health Services LLC
• Ideal Hospice Services Inc
• Iha Olma Specialty Service LLC (IHA Obstetrics & Gynecology Clarkston)
• Iha Ooma Primary LLC (IHA Clarkston Primary Care)

• Orthodontics and Dentofacial Orthopedics Dentistry in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.